The pharmaceutical industry refers to sales calls as detailing. I hate being detailed. However, detailing works. Research has also shown that one can counteract detailing by using this weapon to clarify drug information. Now insurers and prescription drug benefit organizations are taking the academic research and using counterdetailing to decrease drug costs -
Doctors Hear Alternatives To Drug-Firm Sales Pitches

Drummond is a "counterdetailer" -- a paid consultant for a prescription benefit company whose job is to question those sales pitches, to counsel doctors to look at cheaper and generic drugs whenever appropriate. And the rise of this figure in the health care landscape has opened another front in the battle to control prescription drug costs, which have been rising more than 17 percent yearly since 1997.

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Then there are counterdetailers, targeting doctors. The states of West Virginia and Michigan have hired their own counterdetailers to visit doctors and encourage them to prescribe generics whenever possible. Legislators in other states, including Vermont, Massachusetts and Washington, have proposed or passed similar programs. First Health Group Corp., which manages prescription benefit plans in 14 states, reports that the states' interest in counterdetailing is growing fast.

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Persuading doctors to prescribe generics -- and patients to use them -- can bring enormous savings. As explained by Tom Susman of the West Virginia Public Employees Insurance Agency, 43 percent of prescriptions paid by the plan are now generics. If that number grew to 45 percent, he said, the state would save $1 million. That's why he is beginning the state's counterdetailing program, and why the work of people like Marcia Drummond is drawing increased interest.

She works for the prescription benefit company AdvancePCS, which has its own financial reasons for wanting to control drug costs but whose goal is shared by many others, including some generally critical of managed care. New York doctor Robert Goodman, for instance, who runs a program that highlights improper drug-company promotions to doctors, applauds private counterdetailing efforts because "it's essential that doctors get drug information from sources other than just drug company reps."

The AdvancePCS program began several years ago, and now sends out 150 counterdetailers to visit 20,000 of the nation's top prescription-writing doctors each year. The goal, as Drummond described it, is to discuss with doctors the drugs they're prescribing to make sure the patients are getting the most appropriate -- and least expensive -- medications.

All I can say to the pharmaceutical industry is ' Take that!!!'. This is constructive, and I hope the government figures out the benefits of this approach. I only worry that costs do not bias the information given to physicians. I suspect we will read more about this approach over time.